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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334845125
Report Date: 05/14/2021
Date Signed: 05/14/2021 02:04:08 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/01/2021 and conducted by Evaluator Blanca Ruiz-Silva
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20210401094838
FACILITY NAME:DOMINGUEZ FAMILY CHILD CAREFACILITY NUMBER:
334845125
ADMINISTRATOR:SYLVIA DOMINGUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 834-5034
CITY:INDIOSTATE: CAZIP CODE:
92203
CAPACITY:14CENSUS: 5DATE:
05/14/2021
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Sylvia DominguezTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Uncleared adults present in home while children are in care.
INVESTIGATION FINDINGS:
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Due to COVID-19 State of Emergency, on 05/14/2021 at 01:20 p.m., Licensing Program Analyst (LPA) Blanca Ruiz conducted a Tele-inspection with Licensee, Sylvia Dominguez via FaceTime. The purpose of the tele-inspection is to discuss and deliver the findings of the above complaint allegation. A 10-day tele inspection was initiated by LPA Ruiz-Silva on 04/07/2021. Licensee guided LPA on a virtual tour of the facility. LPA Ruiz-Silva observed 5 children in care during this inspection and the following assistants were also present providing care and supervsion: Alexa Crawford and Natalie Delval

The following was discussed with Licensee:
During the process of the investigation, records were reviewed and interviews were conducted. It was reported that an uncleared adult(s) are in the facility during operating hours. It is unknown if the adult(s) in question are interacting with the children and/or providing care and supervision.
Information obtained was unclear who the adult(s) were, and/or if care and supervision was provided to children in care by adult(s) without a criminal record clearance.
Please see LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 09-CC-20210401094838
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: DOMINGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 334845125
VISIT DATE: 05/14/2021
NARRATIVE
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However, information that was provided states that the uncleared adult(s) were present on or about March 2020 to April 2021, when it is alleged the uncleared adult(s) were present. Therefore, it could not be determined that the allegation was made without a reasonable basis.

The licensee has denied that there were any uncleared adults providing care to the children or present at the facility during daycare hours. Information was provided by witnesses who stated that they observe and had contact with the alleged uncleared adults, however there is no substantial evidence that the uncleared adult(s) were residing, working or volunteering at the facility.

After a review of all information obtained, there is conflicting information regarding the alleged adults associated to the facility. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

A Notice of Site Visit was issued on this date. An exit interview was conducted via Facetime with Sylvia Dominguez. A copy of this report was emailed to licensee during the Tele-inspection. The electronic “read receipt” of the e-mailed report acknowledges receipt of this report.

THIS REPORT MUST BE AVAILABLE TO THE PUBLIC FOR THREE YEARS.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2